AHRQ Safety Program for Long-term Care: HAIs/CAUTI
ANSWER KEY for Skills Questions Quiz
Onboarding 2
CAUTI Definitions and Reporting
1. Is the following an example of a CAUTI or a non-catheter symptomatic UTI?
Day 1: The resident has an indwelling urinary catheter inserted in the LTC facility for a bladder
outlet obstruction.
Day 2: The indwelling urinary catheter remains in place.
Day 3: The resident’s indwelling urinary catheter remains in place. The resident has a single oral
temp of 100.2ºF. A urine culture is collected from an indwelling catheter specimen.
Day 4: The indwelling urinary catheter remains in place. No symptoms are documented.
Day 5: The urine culture is positive for Staphylococcus aureus 100,000 CFU/ml.
ANSWER: YES, this is a LTC-acquired CAUTI
Explanation:
 The resident has an indwelling urinary catheter in place;
 The symptoms meet the CAUTI criteria ; An oral fever above 100 oF;
 There is no other explanation for the resident’s symptoms; and
 The resident has a positive urine culture with 100,000 colonies/mL of one species of microorganism
(Staphylococcus aureus).
2. Which of the following criteria would confirm a CAUTI? (Select all that apply.)
a) The resident’s oral temperature is 100.2 ºF and the indwelling catheter specimen is positive for
E. coli 100,000 CFU (105).
b) The resident has purulent discharge around the suprapubic catheter and the catheter specimen
is positive for E. coli 100,000 CFU (105).
c) The resident has a fluctuating change in mental status, and a voided specimen positive for E. coli
100 CFU (102 ) four days after the indwelling catheter was removed.
d) The resident has multiple oral temps of 99.2 ºF, chills, sweating and the indwelling catheter
specimen is positive for E. coli 100,000 CFU (105).
ANSWER: A, D
Explanation:
a) This is a CAUTI. The resident has an indwelling urinary catheter and their fever and culture fit the criteria
for a CAUTI.
b) This is NOT a CAUTI. The CAUTI criteria do not include suprapubic catheters.
c) This is NOT a CAUTI. While the urine culture and symptom fit the criteria for a CAUTI, the indwelling
urinary catheter was removed 4 calendar days before the symptoms were observed. To count as a CAUTI
the indwelling urinary catheter must have been removed within 2 calendar days of observing the
symptoms.
d) This is a CAUTI. The repeated oral temperature of 99.2oF and rigors (chills and sweating) along with the
positive indwelling catheter urine specimen of 100,000 CFU (105) of E. coli meet the CAUTI criteria.
AHRQ Safety Program for Long-term Care: HAIs/CAUTI
ANSWER KEY for Skills Questions Quiz
3. Which scenario fits the decline in activities of daily function (ADL) criteria? (Choose one.)
a) A resident, who was independent with bed mobility, transfers and locomotion last week, now
needs extensive assistance with all 3 ADLs with no apparent cause.
b) A resident who required supervision for eating, personal hygiene and toilet use now needs
limited assistance with toilet use.
ANSWER: A
Explanation:
a) Scenario “A” shows an ADL decline from independence to extensive assistance in 3 ADLs. This would equal
a 3-point increase in overall assistance, meeting the definition of a functional decline.
b) Scenario “B” does not meet the criteria, because it is only a 1-point increase in overall assistance.
4. Which of the residents below has a change in mental status that fits the confusion criteria?
(Choose one.)
a) A resident who is usually able to follow instructions has been unable to focus on activities of
daily living or pay attention to instructions for the last couple of days and has a WBC count of
more than 10,000 leukocytes.
b) A resident suddenly has fluctuating difficulty paying attention and is not making sense during
conversation, and has a WBC of greater than 14,000 leukocytes.
ANSWER: B
Explanation:
a) Scenario “A” does not meet the criteria, because the acute change in mental status is not accompanied
by the appropriate leukocytosis criteria (>14,000 leukocytes).
b) Scenario “B” represents a change in mental status because the change in mental status is acute,
accompanied by leukocytosis. The resident’s behavior is fluctuating and their thinking is disorganized.